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Inhaled β -adrenergic agonists are the most commonly used medications for the treatment of asthma although there is evidence that regular use may produce adverse effects in some patients. Polymorphisms of the β₂-adrenergic receptor ( β₂-AR) can affect regulation of the receptor. Smaller studies examining the effects of such polymorphisms on the response to β -agonist therapy have produced inconsistent results. We examined whether polymorphisms at codon 16 ( β₂-AR-16) and codon 27 ( β₂-AR-27) of the β₂-AR might affect the response to regular versus as-needed use of albuterol by genotyping the 190 asthmatics who had participated in a trial examining the effects of regular versus as needed albuterol use. During the 16-wk treatment period there was a small decline in morning peak expiratory flow in patients homozygous for arginine at B₂-AR-16 (Arg/Arg) who used albuterol regularly. This effect …